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Frailty, hospital use and mortality in the older population: findings from the Newcastle 85+ study

Lookup NU author(s): Emeritus Professor Stuart Parker, Dr Rachel Duncan, Dr Andrew Kingston, Professor Barbara Hanratty, Professor Carol Jagger, Dr Louise Robinson, Emeritus Professor Thomas Kirkwood

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Abstract

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.BACKGROUND: Frailty is a significant determinant of health care utilisation and associated costs, both of which also increase with proximity to death. What is not known is how the relationships between frailty, proximity to death, hospital use and costs develop in a population aged 85 years and over. METHODS: This study used data from a prospective observational cohort, the Newcastle 85+ Study, linked with hospital episode statistics and death registrations. Using the Rockwood frailty index (cut off <0.25), we analysed the relationship between frailty and mortality, proximity to death, hospital use and hospital costs over 2, 5 and 7 years using descriptive statistics, Kaplan-Meier survival curves, Cox's proportional hazards and negative binomial regression models. RESULTS: Baseline frailty was associated with a more than two-fold increased risk of mortality after 7 years, compared to people who were non-frail. Participants classified as frail spent more time in hospital over 7 years than the non-frail, but this difference declined over time. Baseline frailty was not associated with increased time spent in hospital during the last 90 days of life. CONCLUSION: Evidence continues to accrue on the impact of frailty on emergency health care use. Hospital and community services need to adapt to meet the challenge of introducing new proactive and preventative approaches, designed to achieve benefits in clinical and/or cost effectiveness of frailty management.


Publication metadata

Author(s): Keeble E, Parker SG, Arora S, Neuburger J, Duncan R, Kingston A, Hanratty B, Jagger C, Robinson L, Kirkwood T

Publication type: Article

Publication status: Published

Journal: Age and ageing

Year: 2019

Volume: 48

Issue: 6

Pages: 797-802

Print publication date: 01/11/2019

Online publication date: 01/10/2019

Acceptance date: 02/04/2016

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press

URL: https://doi.org/10.1093/ageing/afz094

DOI: 10.1093/ageing/afz094

PubMed id: 31573609


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